Applying the Self-determination Theory to Health-related Quality of Life for Adolescents with Congenital Heart Disease

Purpose: The purpose of this study is to examine the relationship among the three innate needs of SelfDetermination Theory (SDT), self-management of care and adherence to treatment, and the relationship to health-related quality of life (HRQOL) for adolescents with congenital heart disease (CHD). Design and methods: A non-experimental, cross-sectional, correlational design was conducted in a sample of 92 participants with CHD, ages 13 to 18 years. For data analysis, Pearson's correlations were used to explore associations between variables, and the hypotheses were tested using multiple linear regression. Results: Demographic and clinical data were collected: 15 +/- 1.6 yrs; 59% male; 65% White; 43% mild CHD; 25% severe CHD. After controlling for covariates, regression analyses revealed relatedness (beta = 0.64) and competence (beta = 0.79) contributed significant variance to HRQOL, R-2 = 0.56, p < .001: however, autonomy and self-management of care and treatment adherence did not contribute significant variance to HRQOL. Conclusions: This study found that relatedness and competence were significantly associated with HRQOL in adolescents with CHD; however, autonomy and self-management of care and adherence to treatment were not. These findings demonstrate the importance of further examining relatedness and competence in adolescents with CHD. Practice implications: Nursing care should focus on the improvement of social support systems and interventions to increase self-efficacy for adolescents with CHD. (C) 2019 Elsevier Inc. All rights reserved.